Why doctors like me in India are against National Medical Commission Bill
Over the years, it was observed that the Medical Council of India (MCI) — the independent governing body of elected representatives that was given the responsibility to regulate medical education and provisions of practice like ethics and guidelines in India — was somehow not delivering its duty with due diligence and was alleged to have invoked in corrupt practices.
And therefore the need for a separate framework was envisaged, to finally render the MCI redundant.
The idea of a National Medical Commission (NMC) was conceived in 2016, with the basic goal to salvage medical education and its abysmally deteriorating standards in the backdrop of a nefarious syndicate of some corrupt top MCI officials and private medical college owners.
However, as it has finally taken shape and awaits the Parliament’s final nod, the NMC Bill stands diversified and includes some ill thought-out provisions that may have a long-standing negative impact on the practice of medicine, especially modern medicine.
The suggestions of the parliamentary standing committee constituted to research the new bill have been selectively picked and many ignored to suit the agenda of some lobbyists influencing decisions in the present government.
The medical fraternity is largely opposed to the proposed NMC Bill, which has several shortcomings.
Alternate tragedy
The bill allows Ayush doctors to practise modern allopathic medicine just by undergoing a “bridging course”. Practically, all over India, other forms of alternate medicine practitioners are dispensing allopathic medicine, but till now it was unlawful. I wonder why somebody who has opted to practise Ayurveda, Homeopathy or Unani medicine, should be legitimised to use other forms of medicine that she/he has no background in.
On the one hand, the government seems to be interested in reviving alternate forms of medicine, especially Ayurveda, the ancient form of
Indian medicine in its purest form. By bringing in such provisions, it will encourage Ayurveda doctors to abandon the very form and practise “quasi allopathy”.
The scientific fervour and temperament of all forms of medicine will be stifled — this will encourage the spawning of half-baked doctors armed with the licence to err.
On a lighter note, I won’t be surprised if they soon come out with the novel idea of replacing pilots manning aeroplanes with locomotive drivers of the Indian Railways through a “bridging course”!
What perhaps reflects the mindset of this government was famously underlined in the lecture the prime minister delivered in a modern scientific session, where he cited an example from Hindu Mythology: he called Lord Shiva the father of plastic surgery as he had successfully transplanted the head of an elephant onto the body of his son!
Or is it an ingenious attempt by the government to tide over the massive dearth of healthcare infrastructure, especially in rural areas?
Instead of improving the standards of primary and community health centres, they could depute Ayush doctors who would be more than happy to work in dilapidated hospitals for peanuts as salary and Paracetamol as the only drug to dispense.
The government will be absolved of its burgeoning responsibility of providing healthcare, even at a time it spends a shameful three percent of the GDP on healthcare!
Cloud over MBBS
I won’t be surprised if Baba Ramdev runs the biggest chain of Ayurveda medical colleges all over India, which would also be the largest player of healthcare providers by default. Ordinary citizens would be more interested in becoming doctors by doing an Ayurveda course and then cross over to the “bridging course”.
Meanwhile, the tough entrance exam for the conventional allopathic course — the NEET — and an exit exam called NEXT, would definitely raise the standards of medical education, albeit with fewer takers, with easier options available.
Double standards on licentiate
MBBS doctors studying in India would have to now compulsorily pass the licentiate exam, despite going through the tough NEET entrance.
However, for students graduating from few overseas colleges with certain degrees, the NMC authorities will exercise blind discretionary power, discounting their lack of qualifications.
Also, the commission holds arbitrary power to permit people to practise medicine or perform surgery for a certain period without qualifying the National Licentiate Exam.
I have woken up and smelled the coffee: the chaos and confusion and the exceptions made in “special circumstances” are the perfect recipe for brewing corruption.
Remedy for doctors
According to the draft, the NMC will have 25 members, of which only five will be elected representatives (on a temporary basis). It will be a four-tier system with the council sitting at the top of various advisory bodies, which predominantly comprise government-appointed members.
There is poor representation of individual doctors despite their appeal to the government to strike a balance between government appointees and independently-elected members who can work without bias and duress.
Doctors have traditionally been a vulnerable lot in India, and, of late, the community is being subjected to a litany of physical and verbal abuse — with an onslaught of criminal cases being lodged against them at the drop of a hat for perceived acts of negligence.
Recent incidents of the high-handed approach of ministers in the MAX hospital and Fortis Hospital fiascos, buoyed by the frenzy created by a section of the media and populist sentiments, pilloried the medical community and hospitals through biased superfast inquiries carried out by health department doctors; the latter arm-twisted into subservience by their masters.
In such cases, it is the independent panel of medical experts that looks into such matters with a scientific and nuanced approach – they are the only hope to undo gross acts of irresponsible victimisation.
With government representatives ruling the NMC, there is little hope of justice for doctors in future.
Private overreach
The open sale of undergraduate and postgraduate medical seats in private medical colleges was at the nub of corruption in medical education.
But the new Bill removes the “red tape” of regulations required to start a medical college. Also, any private medical college can increase its UG/PG seats without any prerequisite to enhance infrastructure, upgrade teaching facilities and the number of faculty doctors.
Only up to 40 per cent seats in a private medical college can be regulated by the government under the aegis of free seats — which is again open to manipulation — and the government would have no control on the fees charged for the rest of the 60 per cent seats.
Disasters abound
The proposed National Medical Commission Bill is going to spell disaster for the prevalent healthcare system.
Given the MCI needs to be replaced by a more robust, corruption-free proactive integrated system that can regulate undergraduate and postgraduate specialised medical education, research, ethical practice and guidelines, but the NMC Bill — in its present form — is a far cry from that vision.
It is more likely to usher in the spectre of Licence Raj and the government’s vice-like grip over the private healthcare system, the persecution of doctors, and substandard healthcare that legitimises quackery.
It is like rescuing the sheep from the hounds, only to hand them over to the wolves.